Debridement device and method

Abstract

Devices, systems and methods for cutting and sealing of tissue such as bone and soft tissue. Devices, systems and methods include delivery of energy including bipolar radiofrequency energy for sealing tissue which may be concurrent with delivery of fluid to a targeted tissue site. Devices include debridement devices which may include a fluid source. Devices include inner and outer shafts coaxially maintained and having cutters for debridement of tissue. An inner shaft may include electrodes apart from the cutter to minimize trauma to tissue during sealing or hemostasis. Devices may include a single, thin liner or sheath for electrically isolating the inner and outer shafts.

What is claimed is: 
     
       1. A method of surgically cutting and sealing tissue comprising:
 positioning a distal end region of a debridement device at an operative site within a patient, the debridement device having an outer shaft comprising a lumen and a distal end comprising a cutter forming a cutting window, the device further comprising an inner shaft rotatably disposed within the lumen of the outer shaft, the inner shaft having a distal portion comprising a cutter forming a cutting window, the outer shaft and the inner shaft forming a fluid passage therebetween, the device further comprising a bipolar electrode assembly including first and second electrodes that are electrically isolated from one another and positioned at the distal end region, the bipolar electrode assembly further including first and second electrical contacts coupled to the first and second electrodes, respectively, the device further comprising a proximal region opposite the distal end region and including housing maintaining a button, the button being manually transitionable to an activation position; 
 grasping the housing by a hand of a user; 
 cutting tissue at the operative site with the inner shaft cutter and the outer shaft cutter by moving the inner shaft relative to the outer shaft; 
 transitioning the button to the activation position, including simultaneously completing an electrical pathway between each of the first and second electrical contacts and an energy source; 
 delivering bipolar RF energy to the first and second electrodes in response to the button being held in the activation position to apply RF energy to tissue of the operative site; and 
 terminating the delivery of bipolar RF energy to the first and second electrodes upon releasing the button from the activation position. 
 
     
     
       2. The method of  claim 1 , wherein the step of transitioning is performed by a finger of the user's hand otherwise simultaneously grasping the housing. 
     
     
       3. The method of  claim 1 , wherein the step of transitioning includes depressing the button relative to the housing. 
     
     
       4. The method of  claim 1 , further comprising discontinuing the delivery of bipolar RF energy when the button is manipulated away from the activation position. 
     
     
       5. The method of  claim 4 , wherein the button is provided as part of a button assembly, the button assembly further including a biasing member biasing the button away from the activation position. 
     
     
       6. The method of  claim 1 , wherein the button is operatively associated with first and second resilient members, and further wherein the activation position includes the first and second resilient members electrically coupled to the first and second electrical contacts, respectively. 
     
     
       7. The method of  claim 6 , wherein the first and second resilient members are located within the housing. 
     
     
       8. The method of  claim 6 , wherein the step of transitioning the button to the activation position includes establishing electrical communication between a source of energy and the first and second electrical contacts. 
     
     
       9. The method of  claim 1 , wherein the step of delivering bipolar RF energy includes effecting hemostasis at the operative site. 
     
     
       10. The method of  claim 1 , further comprising supplying fluid to the bipolar electrode assembly simultaneously with the step of delivering bipolar RF energy such that the fluid is operatively coupled to the bipolar electrode assembly. 
     
     
       11. The method of  claim 10 , wherein the step of supplying fluid to the bipolar electrode assembly includes delivering the fluid to the bipolar electrode assembly via the fluid passage. 
     
     
       12. The method of  claim 1 , wherein after the step of cutting tissue and prior to the step of transitioning the button, the method further comprising:
 arranging the debridement device in a home position in which the inner shaft cutter is shielded; and 
 enabling an RF energy mode in which the debridement device is maintained in the home position. 
 
     
     
       13. The method of  claim 12 , wherein the step of delivering bipolar RF energy includes supplying bipolar RF energy while the RF energy mode is enabled. 
     
     
       14. The method of  claim 12 , wherein the cutter of the inner shaft includes a cutting surface at a perimeter of the inner shaft cutting window, and further wherein the home position includes the cutting surface disposed within the lumen of the outer shaft. 
     
     
       15. The method of  claim 12 , wherein the home position includes the outer shaft covering the inner shaft cutting window. 
     
     
       16. The method of  claim 12 , wherein the home position includes the cutter of the inner shaft facing a direction opposite the cutter of the outer shaft. 
     
     
       17. The method of  claim 12 , wherein the home position includes the first and second electrodes being exposed for electrically interfacing with tissue of the operative site. 
     
     
       18. A method of surgically cutting and sealing tissue comprising:
 positioning a distal end region of a debridement device at an operative site within a patient, the debridement device having an outer shaft comprising a lumen and a distal end comprising a cutter forming a cutting window, the device further comprising an inner shaft rotatably disposed within the lumen of the outer shaft, the inner shaft having a distal portion comprising a cutter forming a cutting window, the distal end region further comprising an electrode assembly, the outer shaft and the inner shaft forming a fluid passage therebetween; 
 cutting tissue at the operative site with the inner shaft cutter and the outer shaft cutter by moving the inner shaft relative to the outer shaft; 
 arranging the debridement device in a home position in which the inner shaft cutter is shielded; 
 enabling an RF energy mode in which the debridement device is maintained in the home position; and 
 supplying RF energy to the electrode assembly while the RF energy mode is enabled to apply RF energy to tissue of the operative site. 
 
     
     
       19. The method of  claim 18 , wherein the cutter of the inner shaft includes a cutting surface at a perimeter of the inner shaft cutting window, and further wherein the home position includes the cutting surface disposed within the lumen of the outer shaft. 
     
     
       20. The method of  claim 19 , wherein the cutting surface includes a plurality of teeth each terminating at a tip, and further wherein the home position includes the tip of each of the plurality of teeth not being exposed at the outer shaft cutting window. 
     
     
       21. A method of surgically cutting and sealing tissue comprising:
 positioning a distal end region of a debridement device at an operative site within a patient, the debridement device having an outer shaft comprising a lumen and a distal end comprising a cutter forming a cutting window, the device further comprising an inner shaft rotatably disposed within the lumen of the outer shaft, the inner shaft having a distal portion comprising a cutter forming a cutting window, the outer shaft and the inner shaft forming a fluid passage therebetween, the device further comprising a bipolar electrode assembly including first and second electrodes that are electrically isolated from one another and positioned at the distal end region; 
 cutting tissue at the operative site with the inner shaft cutter and the outer shaft cutter by moving the inner shaft relative to the outer shaft; 
 indicating a rotational relationship of the inner shaft relative to the outer shaft appropriate for provision of bipolar RF energy to the first and second electrodes; and 
 supplying bipolar RF energy to the first and second electrodes to apply RF energy to tissue of the operative site.